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ARTICLE 191 Exploring the color of glass: letters of recommendation for female and male medical faculty Discourse & Society Copyright © 2003 SAGEPublications (London, Thousand Oaks, CA and New Delhi) www.sagepublications.com Vol 14(2): 191–220 FRANCES TRIX AND CAROLYN PSENKA [0957-9265 (200303) 14:2; WAYNE STATE UNIVERSITY 191–220; 026277] ABSTRACT. This study examines over 300 letters of recommendation for medical faculty at a large American medical school in the mid-1990s, using methods from corpus and discourse analysis, with the theoretical perspective of gender schema from cognitive psychology. Letters written for female applicants were found to differ systematically from those written for male applicants in the extremes of length, in the percentages lacking in basic features, in the percentages with doubt raisers (an extended category of negative language, often associated with apparent commendation), and in frequency of mention of status terms. Further, the most common semantically grouped possessive phrases referring to female and male applicants (‘her teaching,’ ‘his research’) reinforce gender schema that tend to portray women as teachers and students, and men as researchers and professionals. KEY WORDS:academic medicine, apparent commendation, discourse analysis, gender bias, letters of recommendation, methodology, possessives Gatekeeping practices, including educational requirements, job interviews, and letters of recommendation, all serve to control access to particular positions and the societal benefits that thereby accrue. At the same time gatekeeping practices are all potentially revealing, particularly in times of social change, as institutions replicate themselves and seek to control change. However, studying these prac- tices is challenging, for the higher the social status of the institution, the less public the gatekeeping. We are reminded of Marguerite Yourcenar, the first woman elected to the French Academy since its founding in 1634, and her famous address in 1981 in which she noted that ‘the Academy hadn’t been par- ticularly misogynist. Rather it had merely conformed to the practice of readily putting women on a pedestal, but not yet allowing them to be offered a seat’ (Yourcenar, 1981: 2). Thus, we remember her words, but the gatekeeping 192 Discourse & Society 14(2) practice through which she was elected is shrouded in the privacy of the 39 male members of the time. Not just access, but even interest in gatekeeping practices is limited by the way inequities in the advancement of women and minority groups are often hidden by media attention to the few exceptional women or minorities who do succeed in reaching positions of power. These few seem to repudiate allegations of inequity. But as several law cases have argued, people shouldn’t have to prove exceptional, only equal to others who were promoted at the same time (Selvin, 1993). Statistics of hiring and promotions in professional institutions, along with studies like the one of the Swedish Medical Research Council’s sexism and nepotism in 1 awarding postdoctoral fellowships (Wenneras and Wold, 1997), also call into question gatekeeping practices through which similar people are selected, year in and year out. In this article we analyze a naturalistic set of all the letters of recommendation for successful applicants for faculty positions in a large American medical school for a three-year period in the mid-1990s. We were asked by a member of the Executive Committee for Hiring and Promotion of the medical school to see if the letters of recommendation written for female applicants were systematically dif- ferent to those written for male applicants. The broader social context is that of professions in America in which women’s greater access to educational oppor- tunities in medicine, law, business, seminaries, and academia since the 1970s has not resulted in a commensurate movement of women into positions of power in 2 these institutions and their related organizations (Valian, 1998). Specifically in academic medicine in the USA, the institutional context of this study, in the early 1990s women made up close to 20 percent of medical faculty, and their chances of receiving tenure were half that of male colleagues (Brownlee and Pezzullo, 1992). At that time, there were no female deans of medi- cal schools and of 2000 departments, only 85 had female chairs (Brownlee and Pezzullo, 1992). By the mid-1990s, women accounted for 32 percent of the assis- tant professors, 21 percent of the associate professors, and 10 percent of the full professors (Association of American Medical Colleges, 1996), or 22 percent of medical faculty. What makes this more problematic is the greatly expanded pool for female medical academics. The percentage of females in medical school classes had risen from 8 percent in 1964 to 42 percent in 1994 (Association of American Medical Colleges, 1996: Table B1). And academic medicine as opposed to private medical practice was attractive to a significant number of female medi- cal school graduates. Yet once in academic medicine, women were still taking sig- nificantly longer to advance than men. Even those women who were able to rise in academic medicine reportedly worked under sex-related stress. The resignation in 1991 of Dr Frances Conley from Stanford Medical School, the only female neurosurgeon in her department, brought to public notice what she referred to as ‘demeaning actions and words for twenty-five years’ (Conley, 1998: 120). In the public discussion that ensued, ‘medical professionals of both sexes agreed that academic medicine was a Trix and Psenka: Letters of recommendation 193 particular hothouse of sexist attitudes because of the rigid educational hierarchy, the traditional inequality between doctors and nurses which sets the tone for other working relationships, and the many opportunities to make rude anatomi- cal remarks’ (Gross, 1991: 10). Female medical academics noted the daily slights that were so wearing. A study at Johns Hopkins University School of Medicine in 1990, found that only 38 percent of its female faculty felt welcomed members of the institution, in contrast to 74 percent of its male faculty; and 75 percent of female faculty felt that men had difficulty taking careers of women faculty seriously and accepting them as colleagues (Fried et al., 1996: Table 2). American medical colleges are classic examples of male-dominated institu- tions. Because of the social prestige of medicine in the USA – in the context of academia, medical faculty as a group have the highest salaries – medical colleges have been able to remain more socially conservative in a time of social change. What this implies for letters of recommendation is that gender schema,3 that is, sets of largely non-conscious assumptions about sex differences in men and women (Valian, 1998), that so affect expectations and interpretations of interac- tions, may be more overt here. Amplifying this is the convention that letters of recommendation for medical faculty should be written by heads of department. Heads of departments in medical colleges are overwhelmingly older males whose own experience of medical training took place at times when women were largely nurses, patients, or stay-at-home wives. In contrast to the data of much discourse analysis of racism or prejudice, where the Other is already a group whose agency is backgrounded or suppressed (van Leeuwen, 1996) and whose individuality has been reduced or is non- existent, here we begin with letters for individuals. Theoretically then, the letters for women, or foreigners or African Americans had we sufficient numbers, poten- tially show the process of reduction from individual to Other. In terms of our framework, the least persuasive letters for female applicants describe them in ways that ignore or downplay their professional accomplishments and individual qualities, reducing them to gender schema that see women as less capable and less professional in the demanding work of academic medicine. From a meta-research point of view, we are thus examining a situation in which contrasts will most likely be greater and more obvious than in letters of recommendation for other areas of academia. Like Goffman (1981) in his study of radio talk, in which he built upon its restricted interactional setting – that of the radio announcer who lacks direct feedback – to then propose ways of looking at more complex face-to-face interaction, we too hope to propose ways of think- ing and methods of research that could be applied to data with more subtle dis- tinctions. Although the gender schema that affect both men and women throughout society tend to be unarticulated, examination of these letters of recommendation should provide another way of studying such schema where there is explicit language and meaningful contrasts, along with the better known statistics, hearings (Trix and Sankar, 1998), and law cases. Methodologically this study also wrestles with a situation in which what is not written is potentially 194 Discourse & Society 14(2) salient. Thus the ‘glass’ in the title refers both to the ‘glass ceiling’ that appears to be impeding women from advancing professionally, as well as ‘glass’ or invisible domains in the letters themselves. Previous research on letters of recommendation Studies of letters of recommendation have come largely from the fields of edu- cation (Morisett, 1935; Rayber, 1985), psychology (Cowan and Kasen, 1984; Hatcher, 1983), English (Eger, 1991), sociology (Bell et al., 1992), linguistics (Bouton, 1995; Precht, 1998; Watson, 1987), business (Tommasi et al., 1998), and medicine (DeLisa et al., 1994; Gayed, 1991; Greenburg et al., 1994; Johnson et al., 1998; O’Halloran et al., 1993). Besides these systematic studies, there are also numerous short articles in multiple fields that reflect anecdotally or give advice on writing letters of recommendation. In the systematic studies, the main concerns are reliability (Hatcher, 1983; Morisett, 1935; Tommasi et al., 1998), relative importance of letters of recommendation for screening candidates (DeLisa et al., 1994), deficiencies in letters of recommendation (O’Halloran et al., 1993), cross-cultural differences and evaluations (Bouton, 1995; Gayed, 1991; Precht, 1998), identification of features linked to positive and negative interpret- ations (Greenburg et al., 1994), and sex-linked features or patterns (Bell et al., 1992; Eger, 1991; Hatcher, 1983; Watson, 1987). The features most commonly studied are: length, naming practices and gender identification, negative lan- guage, and sex-linked descriptive terms. An unusual study of particular relevance is that of Eger (1991) who took a psychological approach and profiled 12 male and 12 female writers of letters of recommendation according to the Myers Briggs personality assessment. He then gave each of the writers files on six applicants that contrasted in gender and per- sonality for whom to write recommendations. Eger hypothesized that people would write better letters for people who were more like themselves in personality, ideology, and gender. This he indeed found to be true. This ‘advocacy factor’ as he called it, has relevance for this study in that letters of recommendation for medi- cal faculty positions are overwhelmingly written by men. Among studies of sex-linked features, Watson (1987) analyzed 80 letters of recommendation for graduate study in social sciences (40 letters written by males: half for males, half for females; 40 letters written by females: half for males, half for females). She found that the longest letters were written by female recommenders for female applicants, that men tended to use gender identifica- tions with female applicants twice as often as females did for male applicants, that females used first names of females more frequently than males did, and that comments about appearance and condescending adjectives were used only for female applicants, whereas only men were praised for their sense of humor. We relate some of these to the findings for letters of recommendation for medical fac- ulty. But in our study the contrast of female and male recommenders was not possible because such a relatively small proportion of the recommenders were
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